Nokea
The nurse is teaching a client with a new diagnosis of type 2 diabetes about glipizide (Glucotrol). Which of the following statements by the client indicates a need for further teaching?
- A. I should take this medication 30 minutes before breakfast.
- B. I should avoid drinking alcohol while taking this medication.
- C. I should report sweating or shakiness to my doctor.
- D. I should stop this medication if my blood sugar is normal.
Correct Answer: D
Rationale: Stopping glipizide when blood sugar is normal is incorrect, as type 2 diabetes requires ongoing treatment to maintain control. Options A, B, and C are correct: pre-breakfast dosing maximizes efficacy, alcohol increases hypoglycemia risk, and sweating/shakiness indicate hypoglycemia.
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The nurse is caring for a client with a history of anaphylaxis.
- A. Which instruction is most important for a client with a history of anaphylaxis?
- B. Carry an epinephrine auto-injector at all times.
- C. Avoid over-the-counter medications.
- D. Wear loose-fitting clothing.
- E. Monitor blood pressure daily.
Correct Answer: A
Rationale: Carrying an epinephrine auto-injector is critical for immediate treatment of anaphylaxis, a life-threatening allergic reaction. Avoiding medications, wearing loose clothing, and monitoring blood pressure are less urgent.
A newborn.
While performing a physical examination on a newborn, which of the following nursing assessments should be reported to the doctor?
- A. Head circumference of 40 cm.
- B. Chest circumference of 32 cm.
- C. Acrocyanosis and edema of the scalp.
- D. Heart rate 160 and respirations 40.
Correct Answer: A
Rationale: Strategy: Determine if the assessment is abnormal. (1) correct-average circumference of the head for a neonate ranges from 32 to 36 cm; increase in size may indicate hydrocephaly or increased intracranial pressure (2) normal newborn assessment (3) normal newborn assessment (4) normal newborn assessment
The nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD) who is receiving ipratropium (Atrovent) via inhaler. Which of the following client statements would be of GREATest concern to the nurse?
- A. I use my inhaler four times a day.
- B. I have a dry mouth.
- C. I feel dizzy sometimes.
- D. I rinse my mouth after using the inhaler.
Correct Answer: C
Rationale: Dizziness may indicate systemic absorption or hypoxia, a serious concern in COPD requiring evaluation. Options A, B, and D are less concerning: four times daily is standard, dry mouth is a common side effect, and rinsing is appropriate.
The nurse is caring for a client with a history of Cushing’s syndrome.
- A. Which symptom is expected in a client with Cushing’s syndrome?
- B. Weight loss and fatigue.
- C. Moon face and truncal obesity.
- D. Hypotension and bradycardia.
- E. Polyuria and thirst.
Correct Answer: B
Rationale: Moon face and truncal obesity result from cortisol excess in Cushing’s syndrome. Weight loss, hypotension, and polyuria are more typical of Addison’s disease or diabetes insipidus.
A client one day after a thoracotomy.
Nursing actions on the care plan include: turn, cough, and deep breathe q2h. The nurse understands that the purpose of this nursing action is to
- A. promote ventilation and prevent respiratory acidosis.
- B. increase oxygenation and removal of secretions.
- C. increase pH and facilitate balance of bicarbonate.
- D. prevent respiratory alkalosis by increasing oxygenation.
Correct Answer: A
Rationale: Strategy: Think about each answer choice. (1) correct-primary purpose of this nursing measure is to improve and/or maintain good gas exchange, especially removal of carbon dioxide in order to prevent respiratory acidosis (2) answer choice #1 is better in that it refers to ventilation rather than oxygenation (3) increasing the pH is not desirable (4) respiratory alkalosis is not prevented by this nursing measure